title: Cotinine levels among betel quid users and cigarette smokers in Cambodia.
abstract: Smokeless tobacco use in the form of the betel quid is common in the Western Pacific Region, and yet few studies have determined the nicotine delivery of this habit. During a validation substudy, we randomly sampled 201 adults from a rural province of Cambodia and determined nonparametric (bootstrapped) confidence intervals (CIs) for salivary cotinine levels in tobacco users. We found that cotinine levels for daily betel quid use among women (95% CI = 218.6-350.0 ng/mL) were (1) similar to the levels for daily cigarette smoking in men (95% CI = 240.2-317.1 ng/mL) and (2) significantly higher than the levels for daily cigarette smoking in women (95% CI = 71.8-202.7 ng/mL). The 95% confidence range for these habits exceeded the threshold for addiction. Our findings from rural Cambodia indicate that the typical betel quid habit among women supports the same level of nicotine addiction as the typical cigarette habit in men.
authors.affiliation: 1Loma Linda University, Loma Linda, CA, USA.
authors.forename: Pramil N
authors.initials: PN
authors.lastname: Singh
authors.forename: Zuhair
authors.initials: Z
authors.lastname: Natto
authors.forename: Rituraj
authors.initials: R
authors.lastname: Saxena
authors.forename: Hiya
authors.initials: H
authors.lastname: Banerjee
authors.forename: Daravuth
authors.initials: D
authors.lastname: Yel
authors.forename: Sothy
authors.initials: S
authors.lastname: Khieng
authors.forename: Jayakaran S
authors.initials: JS
authors.lastname: Job
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001114:Areca; D002160:Cambodia / Q000453:epidemiology; D003367:Cotinine / Q000032:analysis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012424:Rural Population / Q000706:statistics & numerical data*; D012463:Saliva / Q000737:chemistry; D012907:Smoking / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D003367:Cotinine
keywords: Cambodia; betel quid; cigarette smoking; cotinine